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目的:分析多发性骨髓瘤(MM)患者初诊或诊治病程中并发髓外病变(EMD)的临床特征和预后。方法:回顾性分析2007年12月~2012年11月在本院住院治疗的213例MM患者中并发EMD的临床特征、生存率以及预后因素。结果:213例MM患者中,21例(9.9%)并发EMD,常见受累部位为软组织。初诊时12例(5.6%)合并EMD(A组),病程中有9例(4.2%)合并EMD(B组)。中位随访20个月,中位总生存(OS)时间为30个月;A、B两组中位OS时间分别为24个月和30个月,两组差异无统计学意义(P=0.88);A组中位缓解持续时间(DOR)为12个月,B组患者出现髓外复发后,再次缓解率仅为44.4%(4/9),获得缓解患者中位DOR为7个月,髓外复发后中位OS仅为7个月。结论:MM合并EMD并不少见,最常见受累部位为软组织。MM患者病程中出现髓外复发后临床缺乏有效的治疗手段,预后差。
Objective: To analyze the clinical features and prognosis of multiple myeloma (MM) patients with newly diagnosed or treated extramedullary lesions (EMD). Methods: The clinical features, survival rates and prognostic factors of 213 consecutive MM patients hospitalized in our hospital from December 2007 to November 2012 were retrospectively analyzed. Results: Of the 213 MM patients, 21 (9.9%) had EMD and the most common site was soft tissue. In the first visit, 12 patients (5.6%) were combined with EMD (group A), and 9 patients (4.2%) were combined with EMD (group B). The median OS was 30 months after a median follow-up of 20 months. The median OS time was 24 months and 30 months in groups A and B, respectively, with no significant difference between the two groups (P = 0.88 ). The median remission duration (DOR) in group A was 12 months. The recurrence rate of extramedullary recurrence in group B was only 44.4% (4/9), and the median DOR in patients with remission was 7 months. The median OS after extramedullary recurrence was only 7 months. Conclusion: It is not uncommon for MM to combine EMD with the most common site being soft tissue. The course of MM patients with extramedullary recurrence after clinical lack of effective treatment, the prognosis is poor.